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DATE RECEIVEDEHD LOG NUMBER <br /> U I . <br /> SAN JOAQUIN COUNTY, 41 <br /> ENVIRONMENTAL HEALTH DEPARTMENT <br /> 1868 East Hazelton Avenue, Stockton, CA 95205-6232 <br /> d Telephone: (209) 468-3420 Fax: (209) 464-0138 Web: www.sjgov.org/ehd <br /> PUBLIC RECORDS RELEASE APPLICATION <br /> APPLICANT: Tina Cheney/ Geno Olson BUSINESS/AGENCY: Neil O. Anderson &Associates <br /> ADDRESS: 902 Industrial Way CITY/STATE/ZIP: <br /> PHONE (1): 209-747-0640 -Tina PHONE (2):209-367-628-1898 -Geno FACSIMILE:209-333-8303 <br /> TENTATIVE*APPOINTMENT DATE: Time: <br /> (Please allow 10 business days from date of application submittal-*Tentative only-must be confirmed) <br /> X CHECK BOX TO EXPEDITE REQUEST-$125 FEE(CASH OR CHECK ONLY)-REQUEST PROCESSED IN 3 BUSINESS DAYS <br /> SIGNATURE OF APPLICANT Tina Cheney-digital signature-ok to expedite DATE November 30, 2012 <br /> Electronic Information: ❑ List❑ Map-Description: <br /> FILE ADDRESS EHD USE ONLY <br /> Street# Street Name City ❑ Unit 1 <br /> J <br /> 1. 1443 Navy Drive i 1�1� (1;c�r� Stockton <br /> 1505 Navy Unit 2 <br /> Drive See Stockton /� �� <br /> �J i C9 n/ <br /> 4. 1023 Pershing Ave Stockton I od-b,No w rip ( <br /> ,[]'U'nit 3 <br /> ft.5. 1041 <br /> 6. 1415 Anderson St. Stockton "`.� / I�����y>��7 a�^�n��p <br /> '�v --r�r ,,❑ Unit <br /> 7. ! <br /> To view the HMMP (Hazardous <br /> 8. Materials Management Plan)go to the ❑ Unit 5 <br /> 9. following website:www.sjoesdata.org <br /> 10. <br /> ,Q Unit 6 <br /> Specific Date Range of Information Requested: From to <br /> ENVIRONMENTAL HEALTH DEPARTMENT FILES <br /> X UNDERGROUND TANK(UST)CLEANUP SITE(LOP) ❑MEDICAL WASTE FACILITY X SOLID WASTE FACILIT IVEHICLE <br /> X OTHER CLEANUP SITE(NON-LOP) ❑HOUSING ABATEMENT ❑WASTE TIRE I D h)�S /v� <br /> X UNDERGROUND TANK(MONITORINGIREMOVAL) ❑FOOD FACILITY ❑DAIRY K,&/"11 H 12 VIZ <br /> X ABOVEGROUND TANK ❑CHICKEN RANCH/DOG KENNEL ❑WASTEWATER TREATMENT PLANT <br /> X HAZARDOUS WASTEIHAZARDOUS MATERIALS ❑MOTEL/HOTEL ❑PUMPER TRUCKIYARDICHEMICAL TOILETS <br /> X TIERED PERMITTED FACILITY ❑POOL/SPA ❑LAND USE APPLICATION SITES <br /> ❑TATTOOIBODY PIERCING ❑COMPLAINTIRESPONSE RECORDS ❑OTHER(PLEASE SPECIFY) <br /> WELL AND SEPTIC PERMIT RECORDS ARE AVAILABLE FOR REVIEW: MONDAY-FRIDAY 8:00 AM-5:00PM(EXCLUDING HOLIDAYS) <br /> 1. List up to ten addresses in the space above. Select the type(s)of files from the list above by checking the appropriate <br /> box(es). At least one file type MUST be selected. Fax to(209)464-0138 or mail to the address indicated above. Address <br /> ranges will not be accepted-for additional assistance with file addresses, contact the EHD. Applications received after <br /> 3:00 pm will be processed the next business day. <br /> 2. The EHD will notify the applicant if any EHD files exist. An appointment for review will be confirmed approximately ten (10) <br /> days after receipt of application. The files will be held for a maximum of five business days for review. Appointments <br /> should be scheduled accordingly. <br /> 3. A file that is actively being worked on by EHD staff ma yy rri�o-t a immecI�attely av ilable�for00K <br /> A new applic tion ay be <br /> submitted when the file is available. i2 �I-lZ `7PQ hc{2,�'� i�uGS�l�I`t r P '�I' k5 �(c/ SCS4. Any file not returned in the same condition as re ease wi f bereorga ze y EHD staff xpens f t e applican . <br /> Future file reviews by the same applicant may require a,!94.25 deposit prior to review. t_BOXED_AREA=EHD USE ONL <br /> L'IZ ` rnN A te, rvr ) 56-4 511-61K J— I a V-eCIVf Z <br /> tOP <br /> l� 5 Lf��7v�41;L , ,,- a qq . vP. <br /> I <br /> ❑ Records provided by Staff-PPR Complete. Staff Name &e_ 1 <br /> F H n do-na 9 4 9 2 <br />